March 19, 2024
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Risky Business

Risky Business

Up, up and away!

An insurance broker has pitched renewals with a 22 percent mark-up for a township. More shockingly, the increase has been attributed to inflation and the fact that property was currently being under-insured, with some buildings that had not been previously inspected. The broker also explained climate change, cyber clauses and...

Database scam

A claims processor for an insurance company engaged in a scam lasting for years where she would use the identities of retirees of a particular organisation to submit fraudulent medical claims. She gained access to the master database of all the retirees of the organisation who were having their medical...

Legal conundrum

A doctor was refused reimbursement for patient care from insurers after she happened to change her name legally. The justification provided by the insurers was that ‘this was not the same person.’ The good doctor in keeping on the right side of the law, changed all legal documents including school...

Keep IDs closer

A former insurance agent was found guilty of receiving fraudulent commissions for unauthorised policies involving many victims. He was found to have written unwanted insurance policies using stolen identities from two colleagues within the industry. The commissions collected this way were then deposited into his own bank accounts. Many senior...

Read, read, read!

A restaurant management company has challenged their BI ruling that they feel was passed based on precedent of covid coverage policies elsewhere. Stating the ruling was a snowball effect, they challenged their ruling saying that the policy did not have a virus exclusion, which was the case in other policies...

Who’s to Blame?

An insurance company has sued a gas station for supplying fuel to an arsonist who revealed his plans to set fire to a building. The insurance company had to pay the arising claim and decided to retrieve the money from the fuel company. Your response?

Car Game

A man traded his car to purchase a different version. The dealer was not aware that he had some outstanding payments. The dealer informed the man that he needed to return the newer car because of the outstanding charges. He did not comply, so the vehicle was repossessed with the...

Vandalising Vegan

A vegan food truck owner reported multiple incidents of vandalism and burglary to his place of business. He reported it as a hate crime and started an online funding campaign for extra support. Upon investigation it was found, he was causing the damage himself. He was charged with insurance fraud,...

Crash!

A giant boulder crashed through a family’s home, causing damages to the structure and hurting a member of the family. While the insurance company originally told them to vacate and stay in a hotel and promised coverage, few hours later they said they would not be paying them anything. Apparently,...

Deceptive coverage

An underwriter signed off insurance policies for huge amounts for a company ahead of its collapse. The company then package the coverage into investment products and sold it to investors. The underwriter insists he was not aware of the deception. Do you believe him?

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